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Department of Orthopaedic Surgery, Sports Medicine Center, The Union Memorial Hospital, Baltimore, Maryland
Department of Nuclear Medicine, Sports Medicine Center, The Union Memorial Hospital, Baltimore, Maryland
Radionuclide bone scans have demonstrated linear up take along the posterior medial border of the tibia in patients with shin splints. This area was investigated by anatomical dissection (14 human cadavers), electro myographic (EMG) and muscle stimulation studies (10 patients), and open biopsy (1 patient). Histologically, the increased metabolic activity manifested on the ra dionuclide scan is due to a periostitis with new bone formation. The soleus muscle and its investing fascia are anatomically and biomechanically implicated in the production of these stress changes, particularly when the heel is in the pronated position. The soleus muscle and fascia form a tough "soleus bridge" over the deep compartment which is thought to be important in pa tients requiring surgical decompression.
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